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General NPI Number Information
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NPI Number | 1700525789
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Entity Type | Individual
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Provider Name | SEAN KILLPACK DMD
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Gender | Male
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Dates
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Enumeration Date | 05/31/2022
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Last Update Date | 05/31/2022
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Provider Practice Location Address
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Address Line | 4 DOCTORS PARK STE D
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City | ASHEVILLE
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State | NC
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Zip | 28801-4523
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Country | US
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Telephone | 828-216-9531
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Fax |
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Provider Business Mailing Address
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Address Line | 119 MEADOW RUN DR
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City | MILLS RIVER
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State | NC
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Zip | 28759-3601
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Country | US
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Telephone | 801-369-4359
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 12709
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License Number State | NC
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